Optimizing contrast-enhanced abdominal CT in infants and children using bolus tracking.

Objective: Manual administration of IV contrast material results in unpredictable injection rates. Our purpose was to determine the effect of bolus tracking on overall abdominal helical CT scan quality, particularly on hepatic enhancement, in children with manually administered contrast media.

Materials And Methods: We compared 33 abdominal helical CT scans of 29 children in whom bolus tracking was used with 22 CT scans of a control group of 21 children in whom bolus tracking was not used.

Abnormalities of the chest wall in pediatric patients.

A variety of focal processes and diffuse abnormalities are found predominantly in children. In addition, thoracic manifestations of trauma differ in children because of increased chest wall compliance. Familiarity with both these abnormalities as well as the common normal variations provides optimal imaging evaluation.

A pattern-oriented approach to splenic imaging in infants and children.

The spleen in infants and children is commonly involved in a variety of pathologic processes. Some of these processes cause isolated splenic disease, whereas others involve the spleen as part of a systemic illness. To facilitate differential diagnosis of splenic abnormalities, a pattern-oriented approach to the imaging evaluation of the pediatric spleen was developed.

MR features of soft-tissue abnormalities due to acute marrow infarction in five children with sickle cell disease.

Objective: The purpose of this investigation was to illustrate a variety of soft-tissue abnormalities on MR imaging encountered in connection with acute marrow infarction in children with sickle cell disease.

Conclusion: Extraosseous abnormalities on MR imaging preclude differentiation of acute marrow infarction from osteomyelitis in children with sickle cell disease.

Cystic fibrosis: combined hyperpolarized 3He-enhanced and conventional proton MR imaging in the lung--preliminary observations.

Four patients with cystic fibrosis (CF) were examined with combined hyperpolarized helium 3-enhanced and conventional proton magnetic resonance (MR) imaging. After inhalation of the polarized 3He gas, single breath-hold, gradient-echo images (resonant frequency of 3He) were obtained to depict lung ventilation. Conventional T2-weighted fast spin-echo (hydrogen) images were also obtained to depict morphologic abnormalities.

Anterior chest wall: frequency of anatomic variations in children.

Purpose: To evaluate the frequency of anterior chest wall variations in children.

Materials And Methods: The computed tomographic (CT) images of 200 consecutive infants and children (114 boys and 86 girls; mean age, 10.5 years; age range, 3 months to 19 years) who underwent chest CT during a 20-month period were evaluated for chest wall variations.

Imaging of pediatric mesenteric abnormalities.

The relative paucity of mesenteric fat seen in the pediatric population can make detection and localization of processes in the mesentery difficult. This pictorial essay reviews pediatric mesenteric disorders and presents criteria that help localize processes to the mesentery. Disorders are categorized by specific patterns of involvement, which can readily be identified by imaging: developmental abnormalities of mesenteric rotation, diffuse mesenteric processes, focal mesenteric masses, and multifocal mesenteric masses.

Effect of neck position on endotracheal tube location in low birth weight infants.

Neck position can affect the position of the tip of the endotracheal tube (ETT) in normal neonates; this has not been systematically investigated in low birth weight (LBW) neonates. It was our intention to determine the effect of neck flexion and extension on ETT position in LBW infants. Eight LBW orotracheally-intubated infants underwent postmortem anteroposterior chest radiographs with the neck in a neutral position, in 55 degrees flexion, and in 55 degrees extension.

Subcutaneous granuloma annulare: MR imaging features in six children and literature review.

Purpose: To describe the magnetic resonance (MR) imaging findings of subcutaneous granuloma annulare (SGA), a rare mass of early childhood.

Materials And Methods: MR imaging studies and clinical records in six children aged 2 1/2-4 years in whom SGA was diagnosed between 1993 and 1997 were retrospectively reviewed. All MR imaging examinations included T1-weighted and fast spin-echo T2-weighted sequences.

Heterogeneous splenic enhancement patterns on spiral CT images in children: minimizing misinterpretation.

Purpose: To (a) determine the appearances and timing of heterogeneous splenic enhancement at spiral computed tomography (CT) and (b) identify variables influencing heterogeneous splenic enhancement.

Materials And Methods: Sequential isolevel (24-mAs) CT images of the spleen obtained at 6-second intervals after initiation of contrast material injection in 112 children (mean age, 4.5 years) were reviewed.

The appearance and significance of extrapleural fluid after esophageal atresia repair.

Objective: The objective is to describe the appearance and evaluate the significance of postoperative extrapleural fluid collections in neonates who have undergone esophageal atresia repair in which an extrapleural surgical approach was used.

Conclusion: Extrapleural effusion in a neonate who has undergone repair of esophageal atresia by an extrapleural approach is associated with a high incidence of anastomotic leakage. Such patients may also be at increased risk for developing a delayed esophageal stricture.

Lymphoproliferative disorders: CT findings in immunocompromised children.

Objective: The objective was to evaluate the CT imaging appearance, distribution of disease, type of immunocompromised state, and outcome of children with Epstein-Barr virus-induced lymphoproliferative disorders.

Materials And Methods: Medical records and imaging studies (from four tertiary children's medical centers) were reviewed for pathologically proven cases of lymphoproliferative disorders in patients less than 20 years old. Trends between the CT imaging appearance, distribution, and type of immunocompromised state and prognosis were noted and analyzed with Fisher's exact test.

Recurrent thrombosis of the superior vena cava associated with activated protein C resistance: imaging findings.

The purpose of this report is to describe imaging findings in activated protein C resistance, a hereditary cause of recurrent thrombosis. The case described was unusual in that a neonate was affected, whereas the vast majority of cases occur in adulthood. This entity is important to diagnose because of the recurrent nature of thromboses and the fact that relatives are often affected.

Diagnostic imaging for pediatric scrotal disorders.

Classification of pediatric scrotal disorders into three typical clinical manifestations--acute scrotal disorders, scrotal masses, and cryptorchidism--provides a practical basis for evaluation with the most commonly used modalities--sonography, scintigraphy, and magnetic resonance (MR) imaging. Acute scrotal disorders of children include acute epididymitis, torsion of an appendix testis or appendix epididymis, and torsion of the spermatic cord. Either scintigraphy or sonography may be used as the first imaging study, and both can aid in distinguishing among the disorders to different degrees.